摘要
目的：明确老年非瓣膜性房颤患者中“胆固醇悖论”是否存在。方法回顾性分析2012年4月至2013年11月入住北京友谊医院医疗保健中心的符合纳入标准的老年非瓣膜性房颤患者作为房颤组，按照病例对照研究1：1匹配原则以同期体检的非房颤患者作为对照组，对比分析两组的总胆固醇（ TC）、低密度脂蛋白胆固醇（LDL - C）、高密度脂蛋白胆固醇（HDL - C）、甘油三酯（TG）水平的变化。结果纳入202例符合标准的非瓣膜性房颤患者，结果发现房颤组 TC、LDL - C 水平分别为4.04±0.81 mmol/ L ，2.27±0.63 mmol/ L；低于对照组，差异具有统计学意义（ P 〈0.05）。且 Logstic 回归分析显示胆固醇水平可作为房颤发生的保护因素存在（ OR ＝0.017，95％置信区间为0.003~0.091，P ＝0.000）。结论老年非瓣膜性房颤患者中 TC、LDL - C 水平较非房颤患者低，“胆固醇悖论”现象确实存在，但产生机制及其所代表的意义仍需要更多临床大型研究去研究证实。
Objective In clinical studies,hypercholesterolemia is an important cardiovascular risk factor,hypercholesterolemia can in-crease the risk for AF. However,several previous studies have demonstrated controversial relationships between cholesterol with AF. The purpose of the stduy was to identify whether the＂cholesterol paradox ＂ really existed in the old patients with non - valvular atrial fibrillation（NVAF）. Methods 202 inpatients with NVAF admitted to the Beijing Friendship Hospital,Captial Medical University between April 2012 to November 2013 were finally enrolled into this study. In accordance with the principle of case - control study 1：1 matching,202 no - atrial fibrillation patients were served as control group. The changes of blood lipid levels：Total cholesterol（TC）,low density lipoprotein（LDL - C）,high density lipopro-tein（HDL - C）,triglyceride（ TG））,in the NVAF group were compared with those of the control group. Results The levels of cholesterol （TC：4. 04 ± 0. 81mmol/ L）,low density lipoprotein（LDL - C：2. 27 ± 0. 63 mmol/ L）were lower in NVAF patients compared with those of the control group,and the difference is significant. Furthermore,the cholesterol can be used as a protective factor of AF patients（OR = 0. 017,95%CI 0. 003 - 0. 091,P = 0. 000）. Conclusion The TC and LDL - C levels were inversely associated with AF,confirming the ＂cholesterol para-dox ＂does exist in AF patients. But it needs more large - scale cohort studies to understand the complex mechanisms and true means.
出处
《临床和实验医学杂志》
2015年第2期146-149,共4页
Journal of Clinical and Experimental Medicine
关键词
心房颤动
胆固醇“胆固醇悖论”
Atrial fibrillation
Cholesterol（TC）
＂Cholesterol paradox ＂
